The doctor will use a ureteroscope during this procedure. The ureteroscope is a very thin instrument that is used to look directly at the inside of the ureter. Some are flexible like a small, very long straw, while others are more rigid and firm.
After the doctor has located the stone through the ureteroscope, he or she can then remove it. There are two ways to remove the stone. Which method the doctor uses during the ureteroscopy is determined by the location, size, and composition of the stone.
Doctors may leave a stent (a flexible tube that keeps the ureter open for drainage) in after the procedure (see Stents for Kidney Stones for more information).
Preparing for the Ureteroscopy
All medical procedures have a risk of injury. Therefore, you will need to sign a consent form prior to the ureteroscopy. You may also be asked to give a urine sample that will be checked for an infection. Therefore, you should avoid urinating for one hour before this part of the procedure.
Throughout the ureteroscopy, you will wear a hospital gown, and a sterile drape that will cover the lower part of your body. In most cases, you will lie on your back with your knees raised and apart. A nurse or technician will clean the area around the urethral opening and apply a local anesthetic. You will then receive a spinal or general anesthetic.
Remember to arrange a ride home afterwards as part of preparing for this procedure.
No incision is made in a ureteroscopy. The doctor begins by gently inserting the tip of the ureteroscope into the urethra, slowly gliding it up into the bladder, and then into the ureter. You should try to relax your pelvic muscles, which will help make this part of the test easier.
The doctor will then locate the stone and either remove it with a cage-like device or shatter it with a special instrument that produces a type of shock wave. A small tube or stent may be left in the ureter for a few days to help the lining of the ureter heal. In most cases, the entire ureteroscopy will take about 15 to 20 minutes.